文章：

量化遗传与环境因素对癌前病变及口腔癌多阶段进展的影响：风险导向预防的应用

Quantifying Genetic and Environmental Factors Accounting for Multistage Progression of Precancerous Lesions and Oral Cancer: Applications to Risk-Guided Prevention

原文发布日期：24 June 2025

DOI: 10.3390/cancers17132114

类型: Article

开放获取: 是

英文摘要：

Background: Oral squamous cell carcinoma (OSCC) is a multifactorial and multistage disease influenced by both genetic susceptibility and environmental risk factors. However, conventional oral cancer preventions are often based on environmental exposures but do not allow for genetic susceptibility and both factors contributing to multistage progressions. This study developed a comprehensive multistate risk model combining both types of factors. Methods: Using data from literature, the researchers built a multistate progression model and calculated transition risks to simulate outcomes in a high-risk population, similar to those eligible for oral cancer screening in Taiwan. Results: The findings showed that OSCC risk varied dramatically across the population, ranging from 362 to over 24,000 cases per 100,000, depending on risk level. The integration of genetic and environmental risk factors into a multistate disease model allows for more accurate risk stratifications of precancerous and invasive OSCC. Frequent screening is more effective, notably in high-risk individuals. Incorporating a health education program provided an additional 2 to 6% reduction in incidence, particularly benefiting higher-risk groups. Simulation findings indicate that tailored screening strategies, particularly when combined with health education interventions, can significantly improve the effectiveness of oral cancer prevention. Conclusions: Quantifying the effects of genetic susceptibility and environmental factors on multistate natural history of precancerous lesions and oral cancer provides a valuable framework for developing the risk-guided policies for oral cancer prevention.

摘要翻译： 

背景：口腔鳞状细胞癌是一种受遗传易感性和环境风险因素共同影响的多因素、多阶段疾病。然而，传统口腔癌预防措施通常仅基于环境暴露因素，未能兼顾遗传易感性及其在多阶段进展中的共同作用。本研究开发了一种整合两类风险因素的综合多状态风险模型。方法：研究人员利用文献数据构建多阶段进展模型，通过计算状态转移风险模拟高危人群（类似台湾地区符合口腔癌筛查条件的人群）的疾病发展结局。结果：研究发现口腔鳞状细胞癌的患病风险在人群中存在显著差异，每10万人中病例数从362例至超过24,000例不等，具体取决于风险等级。将遗传与环境风险因素整合至多状态疾病模型，能够实现对癌前病变和浸润性口腔鳞状细胞癌更精准的风险分层。高频筛查对高危人群效果尤为显著。纳入健康教育项目可使发病率额外降低2%至6%，对高风险群体获益更为明显。模拟结果表明，定制化筛查策略（特别是结合健康教育干预时）能显著提升口腔癌预防效果。结论：量化遗传易感性和环境因素对癌前病变及口腔癌多阶段自然史的影响，为制定风险导向的口腔癌预防政策提供了重要框架。

原文链接：

Quantifying Genetic and Environmental Factors Accounting for Multistage Progression of Precancerous Lesions and Oral Cancer: Applications to Risk-Guided Prevention